Overweight Impacts Histological Disease Activity of De Novo Metabolic Dysfunction-Associated Steatotic Liver Disease After Liver Transplantation

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-11-22 DOI:10.1111/ctr.70039

Alejandro Campos-Murguia, Lea Guetzlaff, Emily Bosselmann, Bastian Engel, Björn Hartleben, Heiner Wedemeyer, Elmar Jaeckel, Richard Taubert, Katharina Luise Hupa-Breier

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Abstract

Background and Aims

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading indication for liver transplantation (LT), but also occurs after LT. The prevalence of de novo MASLD (dnMASLD) after LT, based on both surveillance (svLbx) and indication biopsies (indLbx), is unknown. Furthermore, the impact of the distinct cardiometabolic risk factors on histological disease activity has not been assessed. We aimed to evaluate the prevalence of dnMASLD and the association between the cardiometabolic risk factors and histological disease activity.

Methods

We performed a retrospective single-center study in a LT cohort with indLbx and svLbx. Patients with NAFLD before LT were excluded.

Results

We analyzed 249 patients who underwent either svLbx or indLbx. Forty-eight (19.2%) had either dnMASLD (n = 26/249, 10.4%) or metabolic dysfunction associated steatohepatitis (dnMASH) (n = 22/249, 8.8%). Although dnMASLD/dnMASH was more frequent in indLbx (35.1%, p < 0.01), still 16.5% of patients with svLbx had dnMASLD/dnMASH. While overweight (p < 0.01) and diabetes (p = 0.01) were more frequent in patients with dnMASH, only overweight was associated with histological disease activity in the multivariate analysis. No impact of dnMASLD on the overall survival was observed.

Conclusion

While dnMASLD is more frequent in patients with indLBX, it also occurs in 16.5% of patients without signs of graft dysfunction. Overweight has the strongest impact on histological disease activity and should be monitored carefully after LT.

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超重影响肝移植后新代谢功能障碍相关脂肪肝的组织学疾病活动性

背景和目的：代谢功能障碍相关性脂肪性肝病（MASLD）是肝移植（LT）的主要适应症，但也会在LT后发生。根据监测（svLbx）和适应症活检（indLbx），LT术后新发MASLD（dnMASLD）的发病率尚不清楚。此外，尚未评估不同的心脏代谢风险因素对组织学疾病活动性的影响。我们的目的是评估 dnMASLD 的患病率以及心脏代谢风险因素与组织学疾病活动性之间的关联：我们在一个有 indLbx 和 svLbx 的 LT 队列中进行了一项回顾性单中心研究。结果：我们对249名接受LT治疗的患者进行了分析：我们分析了 249 例接受 svLbx 或 indLbx 的患者。48例（19.2%）患者患有dnMASLD（n = 26/249，10.4%）或代谢功能障碍相关性脂肪性肝炎（dnMASH）（n = 22/249，8.8%）。尽管dnMASLD/dnMASH在indLbx中更为常见（35.1%，p < 0.01），但仍有16.5%的svLbx患者患有dnMASLD/dnMASH。虽然超重（p < 0.01）和糖尿病（p = 0.01）在dnMASH患者中更为常见，但在多变量分析中，只有超重与组织学疾病活动相关。没有观察到dnMASLD对总生存率的影响：结论：虽然dnMASLD在indLBX患者中更为常见，但也有16.5%的患者没有移植物功能障碍的迹象。超重对组织学疾病活动性的影响最大，因此在LT术后应仔细监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.